Jerger 1 Brittany Jerger Professor Vicki Stalbird ENG 1201 7 July 2017 Tommy John Surgery in Little League and MLB Players Fifteen fifteen years I have been playing t ball coach pitch slow pitch or fast pitch softball Fifteen years I have dedicated my life to learning playing and watching softball and baseball Because of my physical and emotional attachment to these games I have incurred many injuries Although I have managed to get countless numbers of injuries I have been fortunate enough to have never needed Tommy John surgery TJS not so lucky are the thousands of little and major leaguers who have undergone the reconstruction surgery As the number of candidates for Tommy John surgery rises Little League and MLB players coaches trainers and fans need to know what Tommy John surgery is and what may cause ulnar collateral ligament damage and how to minimize or eliminate those causes Tommy John surgery is a reconstruction surgery done to the ulnar collateral ligament UCL in an elbow The surgery requires the surgeon to replace the injured UCL with a tendon taken from somewhere else in the body such as his or her wrist forearm toe hamstring hip knee foot or from a donor s body Tommy John Surgery The surgery is named after the first person to have had the surgery done former Los Angeles pitcher Thomas Tommy John Tommy John was pitching on July Picture of Tommy John and Dr Frank Jobe Jerger 2 17 1974 against the Montreal Expos when he felt a severe pain in his pitching elbow after he let go of a pitch in the third inning He shook his arm and took the ball and again after the next pitch he felt the same excruciating pain so he then took himself out of the game He knew that he had to get surgery because he had no other plans for after his baseball career so he turned to Dodgers surgeon Dr Frank Jobe and persisted that he come up with a surgery to fix his elbow And after one year and one day Tommy John returned to the baseball mound and started his first game after his surgery and he said that he felt as good as ever Later Tommy John went on to say It was the most groundbreaking surgery in baseball history Keen It was unheard of to return to the game of baseball after suffering a torn ligament but because of Dr Frank Jobe and his hard work Tommy John went on to win another 164 games over 14 seasons Goldstein One of the main causes for needing ulnar collateral ligament reconstruction surgery Tommy John surgery is pitching or throwing too much Whether it is the number of pitches or balls thrown during a game season or the whole year the main cause for UCL damage is throwing too much If someone asked almost any doctor what the main culprit is he or she will probably say these injuries result from repetitive Jerger 3 overhead throwing much like Dr Thomas John Noonan said during an interview with Dr Frank B Kelly Around the same time as that interview Dr Kelly interviewed several other doctors or experts on Tommy John surgery The other interviewees were Drs James R Andrews James P Bradley Neal S ElAttrache and physical therapist Kevin E Wilk When Wilk was asked about what he thought the main problem was he responded with UCL injuries are due to overutilization not only playing year round baseball but pitching too much in a given game or a given week and not getting enough rest In other words throwing too much in a short amount of time Andrews In an article written by Glenn Fleisig and James Andrews the co authors said that the biggest risk factor to injury is the amount or quantity of pitching whether it be pitching more months per year innings per game or pitches per game They go on to say that averaging more than 80 pitches per game almost quadrupled the chance of surgery and pitching competitively more than eight months per year increased the odds of surgery by fivefold basically saying that if someone pitches more than 80 pitches in a game they are four times more likely to experience UCL damage than those who do not and those who pitch competitively more than eight months out of a year are five times more like to develop UCL damage than those who do not Another specific comment the authors had to make on the topic was that of reassurance to what the doctors above said that repetitive pitching can lead to partial or complete tear of the ulnar collateral ligament UCL Also this article said that pitching more than 100 Jerger 4 competitive innings in a calendar year more than tripled the risk of serious elbow or shoulder injury Fleisig It is obvious that many doctors and specialists believe that the biggest risk factor is the quantity of throwing and in an article written by the American Sports Medicine Institute they also said that the main risk factor is overuse which is in accordance with many other sources Position Statement for Adolescent In another article written by the American Sports Medicine Institute they delve deeper into the previous statement by saying that overuse can result from pitching on multiple teams and pitching year round Also from this article it talks about what surgeons look for when they suspect a person needs TJS Most orthopedic surgeons will see a ligament that has frayed over time from overuse and repetition Position Statement for Tommy John Injuries Another way that throwing too much can cause a need for Tommy John surgery is from the stress that is being put on by throwing the stress comes from the throwing motion that twists and bends the elbow Tommy John Surgery In an article written by Dr David Whiteside and some of his colleagues they state that there are six big things that lead to the destruction of someone s UCL and Picture of Aroldis Chapman Pitching one of those key things is a higher mean pitch count per game also saying what everybody else said in that pitching too much is an issue Whiteside In addition to throwing too much there is also the problem with throwing at your hardest more often Jerger 5 In a research done by doctors at the Henry Ford Hospital in Detroit they found that out of two very similar groups based on age what hand they threw with whether they were starter or relieve pitchers how fast they threw fastballs curveballs sliders and changeups that the difference between the groups was how often they threw their fastballs The group who had had Tommy John surgery pitched fastballs 46 8 of the time while the group that had not had the surgery only threw their fastballs 39 7 of the time The head doctor of the research was Dr Robert A